Life After Breast Implants

More than 40,000 women underwent breast implant removal procedures in the year 2008 according to a study from the National Research Center for Women & Families. And while most women who go through this surgery replace old implants with new ones (as the average lifespan of an implant ranges from 10 to 15 years), many also have their implants completely removed due to complications or simply because they just don’t want them anymore.

It wasn’t until recently that there were even options for women who no longer wanted implants, but still wanted volume. "When you take out the implant, the breast has changed since the implant was originally put in," says Miami plastic surgeon Sean Simon, MD. Over the years, especially if the patient has had children or gained or lost weight, the breast tissue stretches and there is an empty gap left in the breast area that needs to be addressed, he says. And the most popular and reliable way to do that is with a new implant or a breast lift.

New technology and research, however, has found that the "reverse liposuction" approach or more commonly known as fat grafting—using the patient's own fat cells to replace volume—provides a new alternative for women undergoing removal of their implants according to a recent report from the American Society of Plastic Surgeons (ASPS). The procedure, called "simultaneous implant exchange with fat (SIEF)," represents a "conceptual paradigm shift of using natural fat for volumetric augmentation and breast reshaping," says Boston plastic surgeon Daniel Del Vecchio, MD.

The ability to use fat from one part of the body to enhance another is by no means a new phenomenon, but using it to augment the breast is relatively new. "Fat grafting has been around for many years and is more popular for small areas in the face or in more stable areas like the buttocks," says Dr. Simon. In the past, doctors have been wary of injecting fat into the breast, as it is not the best environment for fat to survive, he says. "The other fear was that the new fat could interfere with mammograms—the calcification of fat could be mistaken for a tumor, but with recent studies this has not been found to be the case."

It is important to know that while fat grafting might be a great option for some looking to get rid of their implants, it can only go so far. "Replacing an entire breast with fat grafting is a process. Hundreds of ccs of fat wont survive. It could take as many as four to six procedures and 20 to 30 percent of the fat won't remain," he says.

Bottom line: if you want to consider fat grafting, you need to be well informed and have realistic expectations. "With the state of the art at this moment, replacing on old implant with a new one has a longer-standing history, but with fat grafting, we have been able to eliminate common breast implant complaints like discomfort, rippling, heaviness and the possibility of capsular contracture," says Dr. Simon.

Implants and fat both have inherent advantages and disadvantages, says Dr. Vecchio, "If the current debate is 'implants versus fat', the versatility of fat and the core volume reliability of implants may, in the future, evolve to a place where implants and fat can work together, serving essential functions in the same patient."

If you are considering removing your implants, talk to a board-certified plastic surgeon to find out what is best for you. No two women's breasts are the same and what might be great for one, is not for the other.

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